Geri-psych nursing?

  1. Any nurses work in acute inpatient geri-psych? What is your typical day like? Typical diagnoses on the unit? Are you charge nurse or worker bee? Is this specialty competative?

    (I know there is a psych board, but there it's kinda slow so I thought I'd ask here!)
  2. Visit PAERRN20 profile page

    About PAERRN20

    Joined: Mar '09; Posts: 673; Likes: 802
    RN; from US
    Specialty: 3 year(s) of experience in ER


  3. by   Simply Complicated
    I'm a float nurse in my psych department, so I occasionally work on our medical psych. It's not a true geri psych, but the majority of our older patients go there. We get a variety of patients. Schiz, Bipolar, personality disorders, some depression. Some are more of a normal dementia. But like I said, ours isn't true geri psych, it's medical psych.

    Duties are similar to a regular unit, meds, assessment for any medical issues going on, etc.

    Oh, and I frequently work charge when I work.
  4. by   Kunzieo
    I work acute GeroPsych.

    Typical day-
    RN does the meds (0800, 1400, 1700, 2000) (which usually takes about an hour with 10 pts) does a shift assessment on each patient and a shift note detailing their behaviors over the last 8 hours.
    RN also does admission/discharges, and we don't have a HUC, so we do ALL the admission/discharge proceedings.
    RN is responsible for assessing patients medically and updating the MD board once a shift with medical issues that need to be addressed.
    The AM nurse does rounds with the Psychiatrist and Medical doctors.
    PM nurses spend a lot of time doing behavioral interventions because everyone is sundowning.
    NOC nurse does a lot of the administrative stuff- chart checks, QA checks on charting, tidying up the Dear Doctor notes and Staff Alerts and Family Update sections of the chart.
    We have MHTs (Mental Health Technicians) that are responsible for 15 minute checks around the clock, toileting, turning, repositioning, supervising and interacting with the patients. We have an activities coordinator that comes M-F 9-5 and does groups with the patients.

    This is how it's supposed to go- but it never does The RN spends a lot more time on the floor than the list above indicates, because there's always someone who needs behavioral interventions, a PRN medication, a fluid flush, a catheter (inserted or changed), stool or emesis to be examined, or the MHTs need an extra person to help lift or transfer, or to be in the dayroom to supervise while they do a hoyer lift.... Plus families call A LOT wanting updates, and other facilities call at all hours looking for placement for their problem people...

    Almost exclusively (99.99%) the admitting diagnosis is Dementia with Behaviors.
    Most common etiologies for the Dementia with Behaviors are: Alzheimer's, Parkinson's, and Delirium NOS.
    Rarer etiologies for the Dementia with Behaviors are: Bi-polar disorder, Schizo-affective disorder, Schizophrenia, Lewey Body and Korsakoff's Syndrome. (And a few "been bat-crap crazy their whole life and nobody knows quite why" patients.)

    The RN is the Charge Nurse AND Worker Bee. We occasionally are fortunate to have 2 RNs on, but usually only on days where we are getting 2 admissions OR if we have a group of especially aggressive or mobile (or both) patients that need more 1:1 supervision.

    I don't know if the specialty is competitive in general, but it's definitely not on my unit. We have quite a high rate of RN turnover (but a rather good retention rate for MHTs!) and we always have at least 1 job opening, especially for PM shift (which is probably the most difficult, as the behaviors tend to spike the most in the evenings.)
    Last edit by Kunzieo on Nov 10, '11 : Reason: forgot 1 thing.
  5. by   kool-aide, RN
    It's awful. Like a nursing home, but more hellish.
  6. by   PAERRN20
    Thanks for the replies. How different is it from adult psych? Obviously more medically complex patients, but what else?